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PUJA SHAILESH SITWALA
NPI 1225479199
Internal Medicine - Cardiovascular Disease in Orlando, FL

Active since July 08, 2013PECOS EnrolledAccepts Medicare Assignment
96.08/100
CMS Quality Rating
25 S TERRY AVE STE 310A, ORLANDO, FL 32805(407) 894-4474 Get Directions Write a Review

NPPES record last updated: May 9, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 9, 2025, Oct 9, 2024 (2 updates tracked since 2024).

About Puja Shailesh Sitwala NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PUJA SHAILESH SITWALA (NPI 1225479199) is an individual cardiovascular disease provider in Orlando, Florida, licensed in Florida (ME170903) and active in the NPI registry since July 2013. She is enrolled in Medicare PECOS, is affiliated with Adventhealth Orlando, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1225479199
Entity TypeIndividualFemale
Primary Taxonomy207RC0000X
Provider Legal NamePUJA SHAILESH SITWALA
Location Address25 S TERRY AVE STE 310AOrlando, FL 32805-1843
Mailing Address25 S Terry Ave Ste 310aOrlando, FL 32805-1843 · (407) 894-4474
Phone(407) 894-4474
Sole ProprietorNo
Medical School CMSOtherGraduated 2008
Enumeration DateJuly 8, 2013
Last NPPES UpdateMay 9, 20252 updates tracked since enumeration
NPPES CertifiedMay 9, 2025
✔ NPI 1225479199 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
Licenses✔ Licensed in FL · ME170903✔ Licensed in SC · 83228
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Also ListedInternal MedicineTaxonomy 207R00000X · License 125064208 (IL)
25 S TERRY AVE STE 310A, Orlando, FL 32805
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1701 N 1st StSpringfield, IL 62702-3757 · Phone (217) 545-0182 · Fax (217) 545-4735
Location 2421 Epting AveGreenwood, SC 29646-4041 · Phone (864) 227-6818

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of North Carolina and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Puja Shailesh Sitwala is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5991947111
PECOS Enrollment IDI20191104000002, I20250213002756
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Puja Sitwala reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Florida Hospital Medical Group Inc
1.4 mi
Family Medicine
1115 E RIDGEWOOD ST
Orlando, FL 32803
  • Reassigned Medicare billing, Florida enrollment
  • 3,005 clinicians in this Medicare group
NPI 1225034234 (407) 841-1100
Self Medical Group
372 mi
Family Medicine
207 HOLIDAY ROAD
Mccormick, SC 29835
  • Reassigned Medicare billing, South Carolina and Florida enrollments
  • Also billed through NPI 1215246350 (Florida)
  • 560 clinicians in this Medicare group
NPI 1629382056 (864) 391-5011
Abbeville County Memorial Hospital
391 mi
Critical Access
420 THOMSON CIR
Abbeville, SC 29620
  • Reassigned Medicare billing, South Carolina enrollment
  • 103 clinicians in this Medicare group
NPI 1063449361 (864) 366-5011

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Ct scan of blood vessels of chest with contrast 71275
A CT scan of the chest with contrast is a non-invasive imaging test. It uses X-rays and a special dye to get detailed images of your blood vessels in the chest. This helps in diagnosing conditions related to heart and lungs.
62 services57 patients
Ct scan of heart with evaluation of blood vessel calcium 75571
A CT scan of the heart with evaluation of blood vessel calcium is a non-invasive test that uses X-rays to create detailed images of your heart. It helps in detecting and measuring calcium-containing plaque in the arteries, which can indicate heart disease.
40 services40 patients
Ct scan of blood vessels and grafts of heart with contrast 75574
A CT scan of the heart's blood vessels and grafts with contrast is a diagnostic test. A special dye (contrast) is injected into your veins, which helps create clear images of your heart's vessels and grafts. This helps doctors detect blockages or other abnormalities.
37 services37 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Adventhealth Orlando

Acute Care Hospitals · Orlando, FL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100007
Location601 E Rollins StOrlando, FL 32803 · Orange County
Emergency services Birthing friendly

Self Regional Healthcare

Acute Care Hospitals · Greenwood, SC
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number420071
Location1325 Spring StreetGreenwood, SC 29646 · Greenwood County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32805 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

96.08/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality92.17
Promoting Interoperability100
Improvement Activities40

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Puja Sitwala's NPI number?

The NPI number for Puja Sitwala is 1225479199. It was assigned to this individual provider in the NPPES registry on July 8, 2013.

Where is Puja Sitwala located?

Puja Sitwala practices at 25 S Terry Ave Ste 310A, Orlando, FL 32805. The listed phone number is (407) 894-4474.

What is Puja Sitwala's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Puja Sitwala enrolled in Medicare?

Yes. Puja Sitwala is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Puja Sitwala's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Puja Sitwala reassigns Medicare benefits to 3 organizations: Florida Hospital Medical Group Inc (Orlando, FL), Self Medical Group (Mccormick, SC) and Abbeville County Memorial Hospital (Abbeville, SC). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Puja Sitwala's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Puja Sitwala accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina and First Choice Next and 5 other insurers list Puja Sitwala as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Puja Sitwala affiliated with any hospitals?

According to CMS data, Puja Sitwala is affiliated with Adventhealth Orlando and Self Regional Healthcare.

When was this NPI record last updated?

The NPPES record for Puja Sitwala was last updated on May 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.